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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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BALLARD, LYDIA RENE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: MERCY NORMAN PORTER CLINIC
950 NORTH PORTER
NORMAN OK 73071

Address last updated on 5/13/2024
Phone #: (405) 329-0121 x316
Fax #: (405) 321-0121
County: CLEVELAND
License: 18425
Dated: 7/1/1993
Expires: 7/1/2025
Training Issued: 6/18/1992
Training Expires: 6/30/1993
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1992
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
MERCY NORMAN PORTER CLINIC
950 NORTH PORTER
NORMAN OK 73071

Phone #: (405) 329-0121 x316
Fax #: (405) 321-0121
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
PETER WENDELIN KEUPEN PA 748
AVIS JEWEL LUCAS PA 618
LARA SHIRK APRN 103493
EMMA NICOLE WELCH PA 4496

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